Multi-site lead/system using a multi-pole connection and methods therefor

Abstract

One or more multi-electrode lead coupled to a cardiac sensor/stimulator. Each lead includes a lead body extending from one lead proximal end portion to one lead distal end portion. Each lead further includes at least three tissue sensing/stimulation electrodes disposed along the lead body and at least three terminal connections disposed along the lead proximal end. The tissue sensing/stimulation electrodes are each adapted to sense or stimulate a subject's heart. The cardiac sensor/stimulator includes a signal processing circuit adapted to sense the heart in a first instance and stimulate the heart in a second instance by way of one or more tissue electrode configurations. The configurations are selectable from any combination of the tissue sensing/stimulation electrodes of each implanted lead and an indifferent return electrode. In one example, the signal processing circuit automatically selects the tissue electrode configurations. In another example, a user (manually) selects the tissue electrode configurations.

What is claimed is: 
     
       1. A system, comprising:
 an implantable device configured to sense or receive cardiac signals and deliver cardiac stimulation; and 
 a lead longitudinally extending from a single lead proximal end portion to a single lead distal end portion, the lead including
 a lead body, and 
 four or more tissue electrodes disposed along the lead body, wherein at least two of the four or more tissue electrodes are configured for both sensing and stimulating and wherein all of the four or more electrodes are implantable within, on, or about a heart of a subject; 
 
 the single lead proximal end portion of the lead is sized and shaped to couple to the implantable device, the coupling electrically connecting each of the four or more tissue electrodes to a signal processing circuit of the implantable device; and 
 the signal processing circuit is adapted to sense in a first instance and stimulate in a second instance, the sensing and stimulation occurring by way of one or more selected tissue electrode configurations, wherein the basis of choosing a selected tissue electrode sensing configuration is an analysis of a plurality of different sensing configurations of the four or more tissue electrodes using one or more sense parameters, and wherein the signal processing circuit automatically selects one of the plurality of different sensing configurations of the four or more tissue electrodes for sensing after implantation in view of the analysis of the plurality of different sensing configurations of the four or more tissue electrodes, wherein the signal processing circuit is further adapted to select one of the plurality of different sensing configurations using, at least in part, one or a combination of a blood volume parameter, a spatial distance parameter, or a blood oxygen parameter, each parameter evaluated by way of a logic module. 
 
     
     
       2. The system as recited in  claim 1 , further comprising an external programmer including a telemetry device communicatively couplable to the signal processing circuit of the implantable device,
 the external programmer adapted to receive a user-derived selection of the one or more tissue electrode configurations and communicate the selection to the signal processing circuit. 
 
     
     
       3. The system as recited in  claim 1 , wherein the implantable device includes at least one multi-pole connector cavity, the at least one multi-pole connector cavity sized and shaped to receive and electrically engage with the single lead proximal end portion of the lead, which includes at least four terminal connections. 
     
     
       4. The system as recited in  claim 1 , wherein the one or more selected tissue electrode configurations include at least one tissue electrode positioned to sense or stimulate one or both of a left side of the heart or a right side of the heart. 
     
     
       5. The system as recited in  claim 1 , wherein the analysis of the plurality of different sensing and stimulating configurations of the four or more tissue electrodes includes evaluating the plurality of tissue electrode configurations for each configuration's ability to sense or stimulate the heart. 
     
     
       6. The system as recited in  claim 1 , wherein the implantable device includes one or a combination of a posture sensor, a blood flow sensor, a blood pressure sensor, an impedance sensor, a blood volume sensor, an acceleration or motion sensor, a spatial distance sensor, or a blood oxygen sensor. 
     
     
       7. The system as recited in  claim 1 , wherein the single lead proximal end portion of the lead includes at least four terminal connections. 
     
     
       8. The system as recited in  claim 7 , further comprising at least four conductors contained within the lead body of the lead, the at least four conductors extending between the at least four terminal connections and the four or more tissue electrodes. 
     
     
       9. The system as recited in  claim 1 , wherein the one or more selected tissue electrode configurations include an electrical coupling of at least two of the four or more tissue sensing electrodes. 
     
     
       10. The system as recited in  claim 1 , wherein the lead body of the lead includes a stylet or guidewire receiving cavity and at least one preformed biased portion, the preformed biased portion configured to return to a preformed shape upon removal of a stylet or guidewire from the stylet or guidewire receiving cavity. 
     
     
       11. The system as recited in  claim 1 , wherein the lead includes a first lead and a second lead, each of the first and second leads including at least four or more tissue electrodes. 
     
     
       12. The system as recited in  claim 11 , wherein the one or more selected tissue electrode configurations include a tissue electrode on the first lead and a tissue electrode on the second lead.